Addressing Health Care Market Consolidation and High Prices: The Role of the States

Robert A. Berenson, Jaime S. King, Katherine Gudiksen, Roslyn Murray, and Adele Shartzer (2020) Addressing Health Care Market Consolidation and High Prices: The Role of the States, Urban Institute. Available at: https://www.urban.org/sites/default/files/publication/101508/addressing_h

98 Pages Posted: 16 Aug 2021

See all articles by Robert A. Berenson

Robert A. Berenson

The Urban Institute

Jaime S. King

Faculty of Law, The University of Auckland

Katherine Gudiksen

UCSF/UC Hastings Consortium on Law, Science & Health Policy

Roslyn Murray

Georgetown University

Adele Shartzer

Independent

Date Written: January 1, 2020

Abstract

States have adopted numerous initiatives to address failed competition and high health care prices in provider markets. In this report, we provide a survey of these activities and provide detail on how these and other possible initiatives can address market consolidation both by creative approaches to insert more competition into health care markets and, where market failure seems inevitable, pragmatic regulatory approaches, particularly to limit prices that hospitals and physicians are able to command. We will argue that in important ways, certain approaches to regulating prices actually promotes better-functioning, more competitive markets. We explore in depth the changing role of state attorneys general in addressing high and varying prices, the trade-offs between preventing or limiting mergers versus attempting to restrict the conduct that merged provider systems typically engage in, whether certificate of need laws actually compromise market competition as commonly assumed, and, finally, a range of approaches states can take to regulate payment rates while mounting initiatives to promote more provider competition in health care markets.

Note: Funding: This report was funded by the Commonwealth Fund.

Declaration of Interests: None to declare.

Keywords: healthcare prices, competition, healthcare markets, market consolidation, anti-trust, price transparency,

JEL Classification: I00, I1, I10, I11, I15, I18, H75, P46

Suggested Citation

Berenson, Robert A. and King, Jaime S. and Gudiksen, Katherine and Murray, Roslyn and Shartzer, Adele, Addressing Health Care Market Consolidation and High Prices: The Role of the States (January 1, 2020). Robert A. Berenson, Jaime S. King, Katherine Gudiksen, Roslyn Murray, and Adele Shartzer (2020) Addressing Health Care Market Consolidation and High Prices: The Role of the States, Urban Institute. Available at: https://www.urban.org/sites/default/files/publication/101508/addressing_h, Available at SSRN: https://ssrn.com/abstract=3625905

Robert A. Berenson

The Urban Institute ( email )

2100 M Street, NW
Washington, DC 20037
United States

Jaime S. King (Contact Author)

Faculty of Law, The University of Auckland ( email )

Private Bag 92019
Auckland Mail Centre
Auckland, 1142
New Zealand

Katherine Gudiksen

UCSF/UC Hastings Consortium on Law, Science & Health Policy ( email )

CA
United States

Roslyn Murray

Georgetown University ( email )

Washington, DC 20057
United States

Adele Shartzer

Independent ( email )

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